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Liu Y, Cao B, Wang X, Zhong J, Li Z, Peng R, Zhao D, Gu N, Yang Q. Ferumoxytol-enhanced MR venography for mapping lower-extremity venous networks and evaluating varicose veins in patients with diabetes. Eur Radiol 2024:10.1007/s00330-024-10772-x. [PMID: 38713277 DOI: 10.1007/s00330-024-10772-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/29/2024] [Accepted: 03/12/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES Comprehensive evaluation of lower-extremity varicose veins (VVs) in patients with diabetes is crucial for treatment strategizing. The study aims to assess the feasibility of using ferumoxytol-enhanced MR venography (FE-MRV) for lower-extremity venous mapping and the detection of VVs in patients with diabetes. MATERIALS AND METHODS As part of a phase II clinical trial of a generic brand of ferumoxytol, documented patients with diabetes were enrolled and underwent FE-MRV on a 3-Τ MRI system. Two observers assessed FE-MRV images for image quality, signal intensity ratio (SIR), perforator (PV) diameter, and luminal signal uniformity in deep-to-superficial venous networks with the assessment of intra- and inter-rater reliability. FE-MRV was used to detect lower-extremity VVs. RESULTS Eleven patients underwent FE-MRV without adverse events. The average image quality, as scored by the two observers who assessed 275 venous segments, was 3.4 ± 0.6. Two observers strongly agreed on image quality (κ = 0.90) and SIR measurements (interclass correlation coefficient [ICC]: 0.72) and had good agreement on PV diameter (ICC: 0.64). FE-MRV revealed uniform luminal signals in deep and saphenous venous networks (0.13 ± 0.05 vs 0.08 ± 0.03). Below-knee segments exhibited a significantly higher heterogeneity index than above-knee (p = 0.039) segments. Superficial VVs were observed in 55% (12/22) of legs in 64% (7/11) of patients. Calf muscle VVs were present in 64% (14/22) of legs in 9 patients. CONCLUSION FE-MRV safely and robustly mapped entire lower-extremity venous networks, enabling the detection and pre-treatment evaluation of both superficial, and deep VVs in patients with diabetes. CLINICAL RELEVANCE STATEMENT Ferumoxytol-enhanced magnetic resonance venography offers a "one-stop" imaging strategy for the detection and pre-operative evaluation of both superficial and deep VVs in diabetic patients. KEY POINTS Diabetic patients with VVs are at a higher risk of ulcer-related complications. FE-MRV allowed rapid and comprehensive visualization of the lower-limb venous networks and abdominopelvic veins in diabetic patients. This technique allowed for the detection of superficial and deep VVs in diabetic patients before the development of severe peripheral artery disease.
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Affiliation(s)
- Yuehong Liu
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Bin Cao
- Department of Endocrinology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xinyu Wang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jiali Zhong
- Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Zhenyu Li
- Department of Radiology, Central Hospital Affiliated to Xinxiang Medical University, Xinxiang, China
| | - Ruchen Peng
- Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Dong Zhao
- Department of Endocrinology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
| | - Ning Gu
- Medical School of Nanjing University, Nanjing, China.
| | - Qi Yang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
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Aschauer MA, Keeling IM, Salvan-Schaschl CV, Knez I, Binder B, Raggam RB, Trantina-Yates AE. Gadofosveset-Trinatrium-Enhanced MR Angiography and MR Venography in the Diagnosis of Venous Thromboembolic Disease: A Single-Center Cohort Study. Diseases 2022; 10:diseases10040122. [PMID: 36547208 PMCID: PMC9777805 DOI: 10.3390/diseases10040122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND The aim of this single-center combined prospective/retrospective cohort study was to analyze Gadolinium (Gd)-enhanced MRA (magnetic resonance angiography) and MRV (MR venography) for the diagnosis of pulmonary artery embolism and deep venous thrombosis. The gold standard methods result in major exposure to radiation and a high amount of nephrotoxic iodinated contrast media. This is the first larger contrast-enhanced MR imaging study of acute and chronic venous thromboembolic disease of various stages. METHODS We prospectively examined 88 patients presenting clinical signs of deep vein thrombosis and/or pulmonary artery embolism. A single-session, one-stop shop Gd-enhanced MRA/MRV at 1.5 Tesla, using gradient echo sequences with very short repetition and echo times as well as low flip angles with subtraction and three-dimensional reconstruction, was performed. A diagnosis was made with the consensus of two experienced radiologists. RESULTS We observed excellent MRA image quality in 87% and even higher diagnostic image quality of MRV in 90% of our examinations. Pulmonary artery embolism occurred with deep vein thrombosis in 22%. CONCLUSIONS Gd-enhanced MRA/MRV provided excellent image quality for the diagnosis of venous thromboembolic disease in the majority of cases. It may be particularly useful to plan and follow-up filter implantation and retrieval in the inferior caval vein.
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Affiliation(s)
| | - Ingeborg M. Keeling
- Department of Cardiac Surgery, Medical University of Graz, 8036 Graz, Austria
- Correspondence:
| | | | - Igor Knez
- Department of Cardiac Surgery, Medical University of Graz, 8036 Graz, Austria
| | - Barbara Binder
- Department of Dermatology, Medical University of Graz, 8036 Graz, Austria
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Ye Y, He X, Huang C, Shi C, Deng W, Luo W, Liang J, He Z, Mao H, Liang Q, Chen D, Chen H, Xie G. Comparison Between the Diagnostic Performance of 1.5 T and 3.0 T field Strengths for Detecting Deep Vein Thrombosis Using Magnetic Resonance Black-Blood Thrombus Imaging. Clin Appl Thromb Hemost 2021; 26:1076029620921235. [PMID: 32320276 PMCID: PMC7288798 DOI: 10.1177/1076029620921235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Magnetic resonance (MR) black-blood thrombus imaging (BTI) is an accurate diagnostic technique for detecting deep vein thrombosis (DVT) but to date there have been no studies comparing the diagnostic performance and consistency of this technique at different field strengths. In this study, we evaluated and compared the diagnostic performance of BTI for detecting DVT at 1.5 T and 3.0 T field strengths. METHODS A total of 40 patients with DVT were enrolled in this study from November 2015 up to October 2018. All patients underwent BTI, a contrast-free T1-weighted MR imaging technique for detecting DVT, and contrast-enhanced MR venography (CE-MRV) at 1.5 T or 3.0 T field strengths. The MR data analyses used 1160 segments from the venous lumen of the 40 patients. The signal-to-noise ratio and contrast-to-noise ratio between thrombus and muscle/lumen were calculated to compare BTI at 1.5 T or 3.0 T to determine the image performance for thrombus detection at 1.5 T or 3.0 T. Two physicians blinded to the study evaluated all BTI images and calculated the overall sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV), accuracy, and diagnostic consistency at 1.5 T and 3.0 T. These images and values were compared to control CE-MRV images that had been obtained by 2 senior physicians and used as reference standards. In addition, the reliability and consistency of diagnoses between observers were also evaluated. RESULTS Two study-blind physicians reviewed all BTI images to diagnose thrombus and to determine SE, SP, PPV, NPV, and accuracy. There were no statistical differences in SE, SP, PPV, NPV, or accuracy between the 1.5 T and 3.0 T groups. CONCLUSIONS Black-blood thrombus imaging has high SE, SP, and accuracy for DVT diagnosis both at 1.5 T and 3.0 T field strengths. This noninvasive diagnostic technique, which does not require the use of contrast agents, can be widely used in the clinical screening of DVT and follow-up after treatment.
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Affiliation(s)
- Yufeng Ye
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Xueping He
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Chen Huang
- Medical Imaging Institute of Panyu, Guangzhou, China
- Department of Minimally Invasive Interventional Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Caiyun Shi
- Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Science, Shenzhen, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Wei Deng
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Wenfeng Luo
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Jianke Liang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Zhuonan He
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Huan Mao
- Department of Biomedical Engineering, School of Basic Medical Sciences, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qiwei Liang
- Medical Imaging Institute of Panyu, Guangzhou, China
- Department of Minimally Invasive Interventional Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Dongya Chen
- Physical Examination Section, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Hanwei Chen
- Medical Imaging Institute of Panyu, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Minimally Invasive Interventional Radiology, Guangzhou Panyu Central Hospital, Guangzhou, China
- Hanwei Chen, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou 511400, China.
| | - Guoxi Xie
- Department of Biomedical Engineering, School of Basic Medical Sciences, The Sixth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
- Guoxi Xie, Guangzhou Medical University, Xinzao, Panyu District, Guangzhou, 511436, China.
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Chen H, He X, Xie G, Liang J, Ye Y, Deng W, He Z, Liu D, Li D, Liu X, Fan Z. Cardiovascular magnetic resonance black-blood thrombus imaging for the diagnosis of acute deep vein thrombosis at 1.5 Tesla. J Cardiovasc Magn Reson 2018; 20:42. [PMID: 29936910 PMCID: PMC6016134 DOI: 10.1186/s12968-018-0459-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 05/16/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The aim was to investigate the feasibility of a cardiovascular magnetic resonance (CMR) black-blood thrombus imaging (BBTI) technique, based on delay alternating with nutation for tailored excitation black-blood preparation and a variable flip angle turbo-spin-echo readout, for the diagnosis of acute deep vein thrombosis (DVT) at 1.5 T. METHODS BBTI was conducted in 15 healthy subjects and 30 acute DVT patients. Contrast-enhanced CMR venography (CE-CMRV) was conducted for comparison and only performed in the patients. Apparent contrast-to-noise ratios between the thrombus and the muscle/lumen were calculated to determine whether BBTI could provide an adequate thrombus signal for diagnosis. Two blinded readers assessed the randomized BBTI images from all participants and made independent decisions on the presence or absence of thrombus at the segment level. Images obtained by CE-CMRV were also randomized and assessed by the two readers. Using the consensus CE-CMRV as a reference, the sensitivity, specificity, positive and negative predictive values, and accuracy of BBTI, as well as its diagnostic agreement with CE-CMRV, were calculated. Additionally, diagnostic confidence and interobserver diagnostic agreement were evaluated. RESULTS The thrombi in the acute phase exhibited iso- or hyperintense signals on the BBTI images. All the healthy subjects were correctly identified from the participants based on the segment level. The diagnostic confidence of BBTI was comparable to that of CE-CMRV (3.69 ± 0.52 vs. 3.70 ± 0.47). High overall sensitivity (95.2%), SP (98.6%), positive predictive value (96.0%), negative predictive value (98.3%), and accuracy (97.7%), as well as excellent diagnostic and interobserver agreements, were achieved using BBTI. CONCLUSION BBTI is a reliable, contrast-free technique for the diagnosis of acute DVT at 1.5 T.
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Affiliation(s)
- Hanwei Chen
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
- Medical Imaging Institute of Panyu, Guangzhou, 511400 Guangdong China
| | - Xueping He
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
- Medical Imaging Institute of Panyu, Guangzhou, 511400 Guangdong China
| | - Guoxi Xie
- The Sixth Affiliated Hospital, Guangzhou Medical University, Xinzao, Panyu District, Qingyuan, 511518 Guangdong China
- Department of Biomedical Engineering of Basic Medical School, Guangzhou Medical University, Guangzhou, 511436 Guangdong China
| | - Jianke Liang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Yufeng Ye
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Wei Deng
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Zhuonan He
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Dexiang Liu
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, 511400 Guangdong China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048 USA
| | - Xin Liu
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055 Guangdong China
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048 USA
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The Diagnostic Value of 3-Dimensional Sampling Perfection With Application Optimized Contrasts Using Different Flip Angle Evolutions (SPACE) MRI in Evaluating Lower Extremity Deep Venous Thrombus. Invest Radiol 2018; 52:734-740. [PMID: 28704281 DOI: 10.1097/rli.0000000000000399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the diagnostic performance of noncontrast magnetic resonance imaging utilizing sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE) in detecting deep venous thrombus (DVT) of the lower extremity and evaluating clot burden. MATERIALS AND METHODS This prospective study was approved by the institutional review board. Ninety-four consecutive patients (42 men, 52 women; age range, 14-87 years; average age, 52.7 years) suspected of lower extremity DVT underwent ultrasound (US) and SPACE. The venous visualization score for SPACE was determined by 2 radiologists independently according to a 4-point scale (1-4, poor to excellent). The sensitivity and specificity of SPACE in detecting DVT were calculated based on segment, limb, and patient, with US serving as the reference standard. The clot burden for each segment was scored (0-3, patent to entire segment occlusion). The clot burden score obtained with SPACE was compared with US using a Wilcoxon test based on region, limb, and patient. Interobserver agreement in assessing DVT (absent, nonocclusive, or occlusive) with SPACE was determined by calculating Cohen kappa coefficients. RESULTS The mean venous visualization score for SPACE was 3.82 ± 0.50 for reader 1 and 3.81 ± 0.50 for reader 2. For reader 1, sensitivity/specificity values of SPACE in detecting DVT were 96.53%/99.90% (segment), 95.24%/99.04% (limb), and 95.89%/95.24% (patient). For reader 2, corresponding values were 97.20%/99.90%, 96.39%/99.05%, and 97.22%/95.45%. The clot burden assessed with SPACE was not significantly different from US (P > 0.05 for region, limb, patient). Interobserver agreement of SPACE in assessing thrombosis was excellent (kappa = 0.894 ± 0.014). CONCLUSIONS Non-contrast-enhanced 3-dimensional SPACE magnetic resonance imaging is highly accurate in detecting lower extremity DVT and reliable in the evaluation of clot burden. SPACE could serve as an important alternative for patients in whom US cannot be performed.
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Abstract
Gadolinium has been widely used as the contrast agent of choice for magnetic resonance imaging (MRI). However, gadolinium administration is not always desired due to its inherent enhancement properties and potential side effects (nephrogenic systemic fibrosis). This article reviews gadolinium alternatives, iron-, and manganese- based agents, and their current clinical usage for contrast-enhanced MRI examinations.
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The diagnostic accuracy of magnetic resonance venography in the detection of deep venous thrombosis: a systematic review and meta-analysis. Clin Radiol 2015; 70:858-71. [DOI: 10.1016/j.crad.2015.04.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 03/26/2015] [Accepted: 04/13/2015] [Indexed: 11/23/2022]
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Jah-Kabba AMBM, Kukuk GM, Hadizadeh DR, Träber F, Koscielny A, Kabba MS, Verrel F, Schild HH, Willinek WA. Mapping of autogenous saphenous veins as an imaging adjunct to peripheral MR angiography in patients with peripheral arterial occlusive disease and peripheral bypass grafting: prospective comparison with ultrasound and intraoperative findings. PLoS One 2014; 9:e112340. [PMID: 25405867 PMCID: PMC4236072 DOI: 10.1371/journal.pone.0112340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 10/05/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mapping of the great saphenous vein is very important for planning of peripheral and coronary bypass surgery. This study investigated mapping of the great saphenous vein as an adjunct to peripheral MR angiography using a blood pool contrast agent in patients who were referred for evaluation of peripheral arterial occlusive disease and bypass surgery. METHODS 38 patients with peripheral arterial occlusive disease (21 men; mean age: 71 years, range, 44-88 years) underwent peripheral MR angiography using the blood pool contrast agent Gadofosveset trisodium. Apart from primary arterial assessment images were evaluated in order to determine great saphenous vein diameters at three levels: below the saphenofemoral junction, mid thigh and 10 cm above the knee joint (usability: diameter range: >3 and <10 mm at one level and >3.5 and <10 mm at a neighboring level). Duplex ultrasound was performed by an independent examiner providing diameter measurements at the same levels. Additionally, vessel usability was determined intraoperatively by the vascular surgeon during subsequent bypass surgery. RESULTS Mean venous diameters for MR angiography/duplex ultrasound were 5.4±2.6/5.5±2.8 mm (level 1), 4.7±2.7/4.6±2.9 mm (level 2) and 4.4±2.2/4.5±2.3 mm (level 3), respectively, without significant differences between the modalities (P = 0.207/0.806/0.518). Subsequent surgery was performed in 27/38 patients. A suitable saphenous vein was diagnosed in 25 and non-usability was diagnosed in 2 of the 27 patients based on MR angiography/duplex ultrasound, respectively. Usability was confirmed by intraoperative assessment in all of the 24 patients that received a venous bypass graft in subsequent bypass surgery. In 1 case, in which the great saphenous vein was assessed as useable by both MR angiography and duplex ultrasound, it was not used during subsequent bypass surgery due to the patients clinical condition and comorbidities. CONCLUSION Simultaneous mapping of the great saphenous vein as an imaging adjunct to peripheral MR angiography with a blood pool contrast agent is an alternative to additive duplex ultrasound in patients undergoing subsequent peripheral bypass grafting.
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Arnoldussen CWKP, Strijkers RHW, Lambregts DMJ, Lahaye MJ, de Graaf R, Wittens CHA. Feasibility of identifying deep vein thrombosis characteristics with contrast enhanced MR-Venography. Phlebology 2014; 29:119-124. [DOI: 10.1177/0268355514529697] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To assess the feasibility of identifying deep vein thrombosis characteristics with contrast enhanced magnetic resonance venography. Materials and Methods A total of 53 cases of deep vein thrombosis extending in and/or above the common femoral vein were evaluated by 4 independent observers (2 expert, 2 novice) using pre-determined characteristics to determine the thrombosis present to be acute, sub-acute or old. If present, chronic remnants of a previous deep vein thrombosis were reported. Additionally these image qualifications were compared to the reported duration of complaints. Results In all cases all observers were able to qualify the thrombosis. The interobserver agreement between the experts was excellent (kappa 0.97) and good between expert and novice (kappa 0.82). Thrombosis identified as acute had an average duration of complaints of 6,5 (2–13) days, sub‐acute 13 (8–18) days and old 22 (15–32) days. Conclusion Qualification of thrombosis as acute, sub-acute or old and identification of chronic remnants of DVT with CE-MRV using routinely identifiable characteristics is feasible and reproducible with good to excellent interobserver agreement.
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Affiliation(s)
- CWKP Arnoldussen
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
- Department of Diagnostic and Interventional Radiology, Viecuri Medical Centre, Venlo, The Netherlands
| | - RHW Strijkers
- Department of Vascular Surgery, Maastricht University Medical Centre, The Netherlands
| | - DMJ Lambregts
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
| | - MJ Lahaye
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
| | - R de Graaf
- Department of Diagnostic and Interventional Radiology, Maastricht University Medical Center, The Netherlands
| | - CHA Wittens
- Department of Vascular Surgery, Maastricht University Medical Centre, The Netherlands
- European Vascular Center Aachen-Maastricht, Uniklinik, Aachen, Germany
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Simultaneous MR Arteriography and Venography With Blood Pool Contrast Agent Detects Deep Venous Thrombosis in Suspected Arterial Disease. AJR Am J Roentgenol 2012; 198:1188-95. [DOI: 10.2214/ajr.11.7306] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Rapid MR venography in children using a blood pool contrast agent and multi-station fat-water-separated volumetric imaging. Pediatr Radiol 2012; 42:242-8. [PMID: 21989981 PMCID: PMC3288576 DOI: 10.1007/s00247-011-2254-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 08/15/2011] [Accepted: 08/19/2011] [Indexed: 10/17/2022]
Abstract
A rapid, reliable radiation-free method of pediatric body venography might complement US by evaluating veins in the abdomen and pelvis and by providing a global depiction of venous anatomy. We describe a MR venography technique utilizing gadofosveset, a blood pool contrast agent, in children. The technique allows high-spatial-resolution imaging of the veins from the diaphragm to the knees in less than 15 min of total exam time.
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Ono A, Murase K, Taniguchi T, Shibutani O, Takata S, Kobashi Y, Hashiguchi Y, Miyazaki M. Deep venous thrombosis: Diagnostic value of non-contrast-enhanced MR venography using electrocardiography-triggered three-dimensional half-fourier FSE. Magn Reson Med 2010; 64:88-97. [DOI: 10.1002/mrm.22374] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Blume U, Orbell J, Waltham M, Smith A, Razavi R, Schaeffter T. 3D T(1)-mapping for the characterization of deep vein thrombosis. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2009; 22:375-83. [PMID: 19946791 DOI: 10.1007/s10334-009-0189-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 11/05/2009] [Accepted: 11/12/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this work was to investigate fast T (1)-mapping for the characterization of deep vein thrombosis (DVT). METHODS The accuracy and reproducibility of the T (1)-mapping sequence was tested in phantoms and in 8 healthy volunteers on a 1.5 T clinical scanner using a 32-channel array coil. Furthermore, the feasibility of the technique was tested in 5 patients diagnosed with DVT by measuring the volume and T (1) values of the thrombus at 5 time points over a period of 6 months. RESULTS The results of the phantom and volunteer study showed a high accuracy and reproducibility for the quantification of T (1). The resolution of the T (1)-maps was high enough to identify small anatomical structures. T (1) values derived for normal blood and various other tissues were comparable to those reported in the literature. In all patients, the T (1) times of thrombi showed decreased values (T (1) = 843 +/- 91 ms) in the acute phase and recovered back to normal values of blood (T (1) = 1,317 +/- 36 ms) after 6 months. CONCLUSIONS Measurement of all relevant T (1) values of acute thrombi and normal blood achieved accurate and reproducible results in vivo. Fast T (1) quantification of the thrombus can provide information about tissue characteristics such as thrombus resolution. Such a quantitative MRI technique may be valuable in studying the factors that influence natural resolution and in evaluating treatment effects that enhance this process.
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Affiliation(s)
- Ulrike Blume
- Division of Imaging Sciences, The Rayne Institute, King's College London, St Thomas Hospital, 4th Floor Lambeth Wing, London SE1 7EH, UK.
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Ono A, Murase K, Taniguchi T, Shibutani O, Takata S, Kobashi Y, Miyazaki M. Deep vein thrombosis using noncontrast-enhanced MR venography with electrocardiographically gated three-dimensional half-fourier FSE: Preliminary experience. Magn Reson Med 2009; 61:907-17. [DOI: 10.1002/mrm.21924] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Müller MA, Mayer D, Seifert B, Marincek B, Willmann JK. Recurrent Lower-Limb Varicose Veins: Effect of Direct Contrast-enhanced Three-dimensional MR Venographic Findings on Diagnostic Thinking and Therapeutic Decisions. Radiology 2008; 247:887-95. [DOI: 10.1148/radiol.2473070987] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Meaney JF, Boyle G, O'Keeffe S. Contrast-enhanced magnetic resonance angiography: Current status, theoretical limitations and future potential. Radiography (Lond) 2007. [DOI: 10.1016/j.radi.2007.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McCarthy JR, Kelly KA, Sun EY, Weissleder R. Targeted delivery of multifunctional magnetic nanoparticles. Nanomedicine (Lond) 2007; 2:153-67. [PMID: 17716118 DOI: 10.2217/17435889.2.2.153] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Magnetic nanoparticles and their magnetofluorescent analogues have become important tools for in vivo imaging using magnetic resonance imaging and fluorescent optical methods. A number of monodisperse magnetic nanoparticle preparations have been developed over the last decade for angiogenesis imaging, cancer staging, tracking of immune cells (monocyte/macrophage, T cells) and for molecular and cellular targeting. Phage display and data mining have enabled the procurement of novel tissue- or receptor-specific peptides, while high-throughput screening of diversity-oriented synthesis libraries has identified small molecules that permit or prevent uptake by specific cell types. Next-generation magnetic nanoparticles are expected to be truly multifunctional, incorporating therapeutic functionalities and further enhancing an already diverse repertoire of capabilities.
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Affiliation(s)
- Jason R McCarthy
- Center for Molecular Imaging Research, Harvard Medical School and Massachusetts General Hospital, 149 13th St, Rm 5406, Charlestown, MA 02129, USA.
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Wang MS, Haynor DR, Wilson GJ, Maki JH. Intravascular hematocrit layering in equilibrium phase contrast-enhanced MR angiography of the peripheral vasculature. J Magn Reson Imaging 2006; 24:1393-400. [PMID: 17096397 DOI: 10.1002/jmri.20773] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate intravenous hematocrit (HCT) layering detected in patent calf veins that potentially simulate filling defects seen in deep venous thrombosis (DVT). MATERIALS AND METHODS Flow characteristics, vessel size, and enhancement patterns of veins with HCT layering were examined and compared with those of normal veins in vivo. Ex vivo studies were conducted with conventional and blood pool contrast agents to study the effects of MRI parameters and intrinsic variables on detecting HCT layering. RESULTS HCT layering was detected in high resolution equilibrium phase images in one of six healthy subjects, and five of five patients with peripheral vascular occlusive disease (PVOD). Layering occurred only in deep veins that had significantly slower flow and larger diameter (P < 0.001) compared to normal veins. Enhancement patterns observed in vivo were similar to those found in the ex vivo study. CONCLUSION The HCT layering effect in MR venography has not been previously reported, likely because delayed equilibrium phase venous imaging is not frequently performed. The use of blood pool contrast agents and high resolution equilibrium phase imaging allows intravascular HCT layering to be observed within a 30-60-minute time frame. Several imaging characteristics that distinguish HCT layering from DVT are discussed.
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Affiliation(s)
- Maisie S Wang
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, USA.
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Abstract
In this article, we defined the major areas of active research in clinical MR imaging. Further increases in the number of parallel coils within an imaging array and in advances in parallel imaging pulse sequences and postprocessing will lead to further reductions in imaging time analogous to the impact of multidetector CT on helical CT. The synergism between parallel and high-field imaging will aid the development of high-field imaging. The combined dynamic and hepatic parenchymal enhancement of new contrast agents that have or may soon receive FDA approval will enable improved detection and characterization of liver lesions. The lymphotropic SPIO agents will remain an active area of clinical research to further assess their role in oncologic staging. Molecular imaging contrast research using magnetic particles and MR microscopy will continue to flourish. Screening examinations by MR imaging will re-main an area of research for the short- and intermediate term, with the final outcome dependent more on socioeconomic costs than the underlying capability of achieving high-quality screening studies.
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Affiliation(s)
- W Brian Hyslop
- Department of Radiology, University of North Carolina, 101 Manning Drive, CB #7510, Chapel Hill, NC 27599-7510, USA
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Abstract
Technologic innovations in instrumentation and contrast agents naturally lead to new clinical and research applications in body MRI. Although long-range predictions of innovation are an uncertain process, short-term trends in development are more readily discernable. This review will provide examples of recent developments in magnetic resonance spectroscopic imaging, contrast agent development and molecular imaging, instrumentation, post-processing, and screening in an attempt to describe areas of active research.
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Affiliation(s)
- W Brian Hyslop
- Department of Radiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7510, USA.
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Affiliation(s)
- Florian M Vogt
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany.
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